Provider Demographics
NPI:1447583950
Name:LOPEZ, VIVIANA DEL C (OD)
Entity Type:Individual
Prefix:DR
First Name:VIVIANA
Middle Name:DEL C
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 E OSCEOLA PKWY
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-1607
Mailing Address - Country:US
Mailing Address - Phone:407-483-5906
Mailing Address - Fax:407-483-5908
Practice Address - Street 1:1028 E OSCEOLA PKWY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-1607
Practice Address - Country:US
Practice Address - Phone:407-483-5906
Practice Address - Fax:407-483-5908
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-15
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 4500152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist